Ethan Edward Smith, PA-C

Physician Assistant · Spooner, WI

Individual Active NPI

NPI number 1073215984

Practice location

1180 Chandler Dr
Spooner, WI 54801-2204
Phone
(715) 635-2151

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NPI record

NPI
1073215984
Entity type
Individual (Type 1)
Enumeration date
March 22, 2023
Last updated
September 11, 2024
Certified
September 11, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 8040 WI

Mailing address

400 E 3rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364

About Ethan Smith

Ethan Edward Smith, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1180 Chandler Dr, Spooner, WI 54801-2204. The NPI number 1073215984 was assigned on March 22, 2023 and the record was last updated on September 11, 2024.

Ethan Smith lists a license in the registry: #8040 (WI) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ethan Edward Smith, PA-C?

The NPI number is 1073215984.

What is the phone number of Ethan Smith?

The phone number listed for the practice location is (715) 635-2151.

Where is Ethan Smith located?

1180 Chandler Dr, Spooner, WI 54801-2204.

What is the taxonomy code for Ethan Smith?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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